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Journal of Psychiatry & Neuroscience : JPN logoLink to Journal of Psychiatry & Neuroscience : JPN
. 2000 May;25(3):276–280.

Diltiazem as augmentation therapy in patients with treatment-resistant bipolar disorder: a retrospective study.

P H Silverstone 1, L Birkett 1
PMCID: PMC1407723  PMID: 10863888

Abstract

OBJECTIVE: To examine the efficacy of a slow-release formulation of diltiazem as adjunctive therapy in patients with treatment-resistant bipolar disorder. DESIGN: Retrospective study. PATIENTS: Eight female patients with treatment-resistant bipolar disorder. INTERVENTIONS: Patients were administered diltiazem and monitored for a 6-month period before starting diltiazem and a 6-month period after starting the drug. OUTCOME MEASURES: All patients were seen at least monthly and usually every 2 weeks. The frequency and severity of both depressive and manic episodes were examined during the 6-month period after starting diltiazem, and compared with those during the 6-month period before diltiazem treatment. RESULTS: There was a statistically significant decrease in the frequency and severity of both manic and depressive episodes in these patients after they started treatment with diltiazem, compared with the period before they started treatment with diltiazem (p < 0.001). There was no evidence of side effects requiring patient withdrawal or of drug interactions. CONCLUSIONS: The results support previous suggestions that calcium-channel antagonists may be an effective adjunctive treatment in the management of bipolar disorder. Further controlled clinical studies are needed to confirm this small, open-label, retrospective study.

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Selected References

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  1. Aoki K., Sato K., Kondo S., Yamamoto M. Hypotensive effects of diltiazem to normals and essential hypertensives. Eur J Clin Pharmacol. 1983;25(4):475–480. doi: 10.1007/BF00542114. [DOI] [PubMed] [Google Scholar]
  2. Bowden C. L. Role of newer medications for bipolar disorder. J Clin Psychopharmacol. 1996 Apr;16(2 Suppl 1):48S–55S. doi: 10.1097/00004714-199604001-00006. [DOI] [PubMed] [Google Scholar]
  3. Brunet G., Cerlich B., Robert P., Dumas S., Souetre E., Darcourt G. Open trial of a calcium antagonist, nimodipine, in acute mania. Clin Neuropharmacol. 1990 Jun;13(3):224–228. doi: 10.1097/00002826-199006000-00004. [DOI] [PubMed] [Google Scholar]
  4. Caillard V. Treatment of mania using a calcium antagonist--preliminary trial. Neuropsychobiology. 1985;14(1):23–26. doi: 10.1159/000118196. [DOI] [PubMed] [Google Scholar]
  5. Chou J. C. Recent advances in treatment of acute mania. J Clin Psychopharmacol. 1991 Feb;11(1):3–21. [PubMed] [Google Scholar]
  6. De Beaurepaire R. Treatment of neuroleptic-resistant mania and schizoaffective disorders. Am J Psychiatry. 1992 Nov;149(11):1614–1615. doi: 10.1176/ajp.149.11.1614. [DOI] [PubMed] [Google Scholar]
  7. Dubovsky S. L. Calcium antagonists in manic-depressive illness. Neuropsychobiology. 1993;27(3):184–192. doi: 10.1159/000118978. [DOI] [PubMed] [Google Scholar]
  8. Fabian J. E., Silverstone P. H. Diltiazem, a calcium antagonist, partly attenuates the effects of dextroamphetamine in healthy volunteers. Int Clin Psychopharmacol. 1997 Mar;12(2):113–120. doi: 10.1097/00004850-199703000-00007. [DOI] [PubMed] [Google Scholar]
  9. Garza-Treviño E. S., Overall J. E., Hollister L. E. Verapamil versus lithium in acute mania. Am J Psychiatry. 1992 Jan;149(1):121–122. doi: 10.1176/ajp.149.1.121. [DOI] [PubMed] [Google Scholar]
  10. Giannini A. J., Houser W. L., Jr, Loiselle R. H., Giannini M. C., Price W. A. Antimanic effects of verapamil. Am J Psychiatry. 1984 Dec;141(12):1602–1603. doi: 10.1176/ajp.141.12.1602. [DOI] [PubMed] [Google Scholar]
  11. Goodnick P. J. Nimodipine treatment of rapid cycling bipolar disorder. J Clin Psychiatry. 1995 Jul;56(7):330–330. [PubMed] [Google Scholar]
  12. Grunze H., Walden J., Wolf R., Berger M. Combined treatment with lithium and nimodipine in a bipolar I manic syndrome. Prog Neuropsychopharmacol Biol Psychiatry. 1996 Apr;20(3):419–426. doi: 10.1016/0278-5846(96)00006-1. [DOI] [PubMed] [Google Scholar]
  13. Höschl C. Do calcium antagonists have a place in the treatment of mood disorders? Drugs. 1991 Nov;42(5):721–729. doi: 10.2165/00003495-199142050-00001. [DOI] [PubMed] [Google Scholar]
  14. Höschl C., Kozený J. Verapamil in affective disorders: a controlled, double-blind study. Biol Psychiatry. 1989 Jan 15;25(2):128–140. doi: 10.1016/0006-3223(89)90157-1. [DOI] [PubMed] [Google Scholar]
  15. Jacobs D., Silverstone T. Dextroamphetamine-induced arousal in human subjects as a model for mania. Psychol Med. 1986 May;16(2):323–329. doi: 10.1017/s0033291700009132. [DOI] [PubMed] [Google Scholar]
  16. Kennedy S., Ozersky S., Robillard M. Refractory bipolar illness may not respond to verapamil. J Clin Psychopharmacol. 1986 Oct;6(5):316–317. [PubMed] [Google Scholar]
  17. Lenzi A., Marazziti D., Raffaelli S., Cassano G. B. Effectiveness of the combination verapamil and chlorpromazine in the treatment of severe manic or mixed patients. Prog Neuropsychopharmacol Biol Psychiatry. 1995 May;19(3):519–528. doi: 10.1016/0278-5846(95)00033-r. [DOI] [PubMed] [Google Scholar]
  18. Pazzaglia P. J., Post R. M., Ketter T. A., George M. S., Marangell L. B. Preliminary controlled trial of nimodipine in ultra-rapid cycling affective dysregulation. Psychiatry Res. 1993 Dec;49(3):257–272. doi: 10.1016/0165-1781(93)90066-p. [DOI] [PubMed] [Google Scholar]

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